Comparative Effects of CPP-ACP and Xylitol F-Varnishes on the Reduction of Tooth Erosion and Its Progression

Abstract Evaluated the effect of CPP-ACP/NaF and xylitol/NaF varnishes in reduce erosion and progression of erosion. Forty enamel blocks were divided into four groups (n=10): G1=CPP-ACP/NaF varnish (MI varnishTM); G2=xylitol/NaF varnish (Profluorid®); G3=NaF varnish (Duraphat®, positive control) and G4=deionized water (MilliQ®, negative control). Samples were immersed in Sprite ZeroTM (pH 2.58, 4x/day, 3 days), in between immersions, the specimens stayed in artificial saliva. After 3 days of erosion, the eroded area was divided in two (half of one received an additional varnish layer while the other half repeated the same 3-day erosion cycle). The 3D, non-contact profilometry technique was used to determinate tooth structure loss (TSL) and surface roughness (SR). Scanning electron microscopy (SEM) and 3D images were utilized to evaluate the topography of the samples. Mann-Whitney, one-way ANOVA and Tukey tests were used (significance level of 0.05%). SEM and 3D images were descriptively evaluated. After 3 or 6 days of erosion, all tested varnishes were better than G4 (p<0.05) for TSL and SR. In addition, G1 had lower values for TSL than G3 (p<0.05) after 3 days of erosion. Under SEM and 3D images observation, all groups presented porosity, irregularities and depressions on the surface enamel after 3 and 6 days of erosion, more pronounced in G4. An application of topical NaF varnishes was effective in reducing TSL and enamel roughness after erosion challenges, being the CCP-ACP/NaF varnish more effective than NaF varnish and water after 3 days of erosion.

摘要：本研究评估了CPP-ACP/氟化钠（CPP-ACP/NaF）与木糖醇/氟化钠（xylitol/NaF）涂剂对牙釉质酸蚀及其进展的抑制效果。将40颗牙釉质块分为4组（每组n=10）：G1为CPP-ACP/氟化钠涂剂（MI varnishTM）；G2为木糖醇/氟化钠涂剂（Profluorid®）；G3为氟化钠涂剂（Duraphat®，阳性对照）；G4为去离子水（MilliQ®，阴性对照）。样本每日4次浸泡于雪碧零度™（Sprite ZeroTM，pH 2.58）中，持续3天；两次浸泡间隔期间，样本置于人工唾液内。经3天酸蚀后，将酸蚀区域均分为两部分：其中一半区域额外涂布一层受试涂剂，另一半则重复前述3天的酸蚀循环。采用非接触式三维轮廓测量技术测定牙体组织丢失量（tooth structure loss, TSL）与表面粗糙度（surface roughness, SR）；利用扫描电子显微镜（Scanning Electron Microscopy, SEM）与三维图像对样本的表面形貌进行评估。采用曼-惠特尼U检验、单因素方差分析（one-way ANOVA）与图基检验开展统计学分析，检验水准设定为0.05%，并对扫描电子显微镜与三维图像结果进行描述性评价。经3天或6天酸蚀后，所有受试涂剂组的牙体组织丢失量与表面粗糙度均显著优于G4组（p<0.05）。此外，酸蚀3天后，G1组的牙体组织丢失量低于G3组（p<0.05）。扫描电子显微镜与三维图像观察显示，经3天、6天酸蚀后，所有组别牙釉质表面均存在孔隙、不规则结构与凹陷，其中G4组的病变表现最为显著。局部应用氟化钠涂剂可有效降低酸蚀刺激后的牙体组织丢失量与牙釉质粗糙度，其中CPP-ACP/氟化钠涂剂在酸蚀3天后的效果优于氟化钠涂剂与去离子水组。